Wednesday, August 31, 2011

The End of Life

As I end my rotation in hospice and palliative medicine, I struggle to construct a reflection of my experience. I am not even sure of the reasons. I was too engrossed or too detached? Too close or too far? So I will just have to counsel myself...

So what came to my mind when I realized that this was my last day? I thought, I was leaving PGH and going back to my mother hospital.

So what did I feel when I thought of this? I felt relieved because I will no longer be subjected to very stressful situations but at the same time I felt sad because I am going to leave a good place of learning and this will also end a wonderful experience.

Let us probe on the wonderful experience, what were these experiences? I enjoyed the home visits especially going to Madre de Amor in Laguna. I was so thrilled to find out that a community-based organization is doing hospice care to home bound patients. And these are volunteers both from the medical and non-medical field. If only there could be more such foundations around the country. Another experience I enjoyed so much was teaching the students and sharing with other doctors the importance and significance of the psychosocial-spiritual dimension of care. I enjoyed sharing my thoughts and insights about the spiritual aspect and how it greatly helps in health care. The other activities were also fun and exciting. I also have to point out the wonderful experience I had with the people I worked with, especially with my fellow residents and the fellows. I hope this is the start of a long-lasting friendship.

What else? I still have a lot in mind. But this will suffice for now. Maybe next time I could articulate them better.

Sunday, August 28, 2011

A Short Analysis of the Current UMC Situation in the Philippines

The current situation of the UMC in the Philippines has made people, both clergy and lay, give differing opinions. My task is to stepback, reflect their thoughts and hopefully clarify what is going on.

A lot of minds are in the opinion that the current situation stems from one big issue that brought forth several sub-issues. Another group is in the opinion that there are several different unrelated issues. But I say that there are indeed several issues but each issue affects the other. What does this imply?

This means, for the first group, it is just one great issue that when that great issue is resolved, the rest of the sub-issues are also solved. This also means, for the second group, that when one issue is resolved, only that issue is resolved but the other issues are not affected in any way. Both are wrong. Because, the current situation are a product of several inter-related issues, one issue that is resolved affects the others as well (either in good or bad ways.)

Now let me deal with the first issue. That is of the legal team of LT led by AFR and all those against it. (Let us just say there are two groups, for easy distinction.) The first group wants LT to face and possibly be tried for the alleged immorality he committed. He was put in suspension so a supposed unbiased investigation can be done. But of course we know what happened. He did not accede to the suspension for legal reasons. The legal team contended the suspension with several reasons among them are that due process was not done, lack of authority by the CollOB, among others. The first group wanted LT to be tried for ethical reasons. They wanted the bishop's questionable morality and dignity be clarified. For them, a spiritual leader that deals with spiritual matters should put first and foremost in his priority morality, ethics, religion and spirituality. They wanted to see LT practice the Christian virtues. The second group (legal), on the other hand, wanted justice to prevail. Justice in this sense means observation of the rules of order, proper procedure, and execution of the law to the letter. If these were not observed, then there is no case of immorality to be resolved and no suspensions should be done ab initio. (Just think about the case of the Alabang Boys or if you are old enough, you may still remember the OJ Simpson case.) In essence, it is dignity vs. technicality.

If the two differing groups look at the same issue in two different lenses, how can they reconcile the issue when they cannot even meet on the same ground? Ultimately, they will just end up talking without even communicating. And the issue will remain unresolved.

What about the other issues? Because there are consequences to each and everyones action, the actions of LT led to several other issues. One is the argument that the Council of Bishops are meddling with the Philippine internal affairs. (Just a note: please stop referring to the Council of Bishops as US meddling because the members there are not all from the US, we are doing the non-American members injustice.) Because of this argument, in a meeting in Nueva Ecija, a group declared independence from the "US-controlled UMC" (sic). Now the problem here is funny. The people present during the declaration apparently did not understand each other. A certain JFZ proudly reported that the declaration of independence is the birth of the Philippine Methodist Church. The SEC registration for this is allegedly on process. Even LT acknowledged that this Nueva Ecija group is not UMC. (Instead of PMC, the name reserved in SEC was IMP.) However, other people present during that declaration of independence has different views. For them, their participation was simply a statement of DESIRE to be independent. Not necessarily a secession or establishment of another church. This includes LT, despite being present their and acknowledging that another church was established there, claims that he is still UMC. The participants in the Nueva Ecija Declaration are confused if their actions established a new church or not. Regardless, the UMC respects their right if they want to leave or they want to stay. They only need to confirm and affirm to which is their loyalty.

I did not realize that this short analysis could be this long already... Of course there are other issues. Most importantly the WestMidPAC issue. That may warrant another article.... tbc...

Wednesday, August 17, 2011

Conquering Death

My patient died yesterday. He was already under the hospice and palliative care because his cancer was stage 4 in its terminal phase. However, his family was not ready to give up. They trusted God will do a miracle. The patient was having a hard time to accept his illness. His kids are too young to lose a father. He was hopeful he could still go back to work to be able to provide a good future for his family. He was praying that God would hear him. Death was their enemy and they were fighting it with everything they have.

Palliative medicine teaches me that whenever cure is almost an impossibility, care should always be the goal. A respectable and peaceful death is a great help to the family and to the patient.
However, Christian perspective teaches us that death is an enemy we have conquered and we will conquer. Is palliative medicine looking death as an enemy? What does it mean when it treats death as a natural process of life? That death should not be a violent death or a painful death? Would palliative medicines' perspective then be compatible with Christian teaching? Or are we looking at death with two different meanings?
I will have to visit my patient's family over the weekend at the wake. I may have to do bereavement care in the coming weeks. Then, I will know if they faced death and if they think our patient was able to conquer death...

Monday, August 1, 2011


I am excited in my rotation in Hospice and Palliative Medicine. I pray that some of my questions about the relationship of theology and medicine will somehow be answered one way or another.

My most anticipated part is my exposure to the actual use of Spirituality in patient care. Although I have already used the Spiritual history in some of my patients, I have never been exposed to using it in such great number of patients. Plus, most of my patients will be terminally ill and so I expect them to have more or less some spiritual problems.

I expect that whenever my patients will share to me their spirituality, I will have an opportunity to offer them Christ as their Lord and Savior. Of course, that means I have to be very shifty as a doctor and as a pastor. I pray that my month-long stay will be a blessing to the many people